Autonomic Function and Cerebral Autoregulation in Patients Undergoing Carotid Endarterectomy

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概要

• 論文の詳細を見る

• Background: Carotid endarterectomy (CEA) is the first-line treatment in severe carotid stenosis to prevent stroke. Because of methodological limitations, the acute impact of CEA on baroreflex function and cerebral autoregulation is not well defined and was therefore investigated by applying a novel algorithm. Methods and Results: Systemic arterial blood pressure, ECG and respiration during metronomic breathing and Valsalva maneuver were continuously recorded in 18 patients with carotid stenosis before and after CEA, and in 10 healthy controls. Baroreflex sensitivity, frequency spectra of RR intervals and indices for cerebral autoregulation were evaluated by trigonometric regressive spectral analysis. Compared with the controls, patients had impaired baroreflex sensitivity. Baroreflex sensitivity and frequency spectra were not changed by CEA. Cerebral autoregulation of patients with carotid stenosis as calculated by phase shift was reduced compared with controls but it improved significantly after CEA. Improvement of cerebral autoregulation was independent of changes in cerebral blood flow velocity. Conclusions: Baroreflex sensitivity and cerebral autoregulation are impaired in patients with carotid stenosis, conferring a high stroke risk. CEA improves cerebral autoregulation, but does not affect baroreflex sensitivity. For further risk reduction, interventional approaches targeting baroreflex function need to be considered. (Circ J 2010; 74: 2139-2145)

• 2010-09-25

著者

• Mense Lars

  Autonomic and Neuroendocrinological Laboratory, Department of Neurology, Dresden University of Techn

• Reimann Manja

  Autonomic and Neuroendocrinological Laboratory, Department of Neurology, Dresden University of Techn

• Rüdiger Heinz

  Autonomic and Neuroendocrinological Laboratory, Department of Neurology, Dresden University of Techn

• Gahn Georg

  Autonomic and Neuroendocrinological Laboratory, Department of Neurology, Dresden University of Techn

• Reichmann Heinz

  Autonomic and Neuroendocrinological Laboratory, Department of Neurology, Dresden University of Techn

• Hentschel Hjördis

  Autonomic and Neuroendocrinological Laboratory, Department of Neurology, Dresden University of Techn

• Ziemssen Tjalf

  Autonomic and Neuroendocrinological Laboratory, Department of Neurology, Dresden University of Techn

• Gahn Georg

  Autonomic And Neuroendocrinological Laboratory Department Of Neurology Dresden University Of Technol

• Mense Lars

  Autonomic And Neuroendocrinological Laboratory Department Of Neurology Dresden University Of Technol

• Reimann Manja

  Autonomic And Neuroendocrinological Laboratory Department Of Neurology Dresden University Of Technol

• Ziemssen Tjalf

  Autonomic And Neuroendocrinological Laboratory Department Of Neurology Dresden University Of Technol

• Reichmann Heinz

  Autonomic And Neuroendocrinological Laboratory Department Of Neurology Dresden University Of Technol

• Rudiger Heinz

  Autonomic And Neuroendocrinological Laboratory Department Of Neurology Dresden University Of Technol

• Hentschel Hjordis

  Autonomic And Neuroendocrinological Laboratory Department Of Neurology Dresden University Of Technol

関連論文

• Autonomic Function and Cerebral Autoregulation in Patients Undergoing Carotid Endarterectomy
• Autonomic Function and Cerebral Autoregulation in Patients Undergoing Carotid Endarterectomy

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